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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
176 to 200 of 463 Research Studies DisplayedRaman G, Adam GP, Halladay CW
Comparative effectiveness of management strategies for renal artery stenosis: an updated systematic review.
This study compared benefits and harms of percutaneous transluminal renal angioplasty with stent placement (PTRAS) versus medical therapy alone in adults with atherosclerotic renal artery stenosis (ARAS). The strength of evidence regarding the relative benefits and harms of PTRAS versus medical therapy alone for patients with ARAS is low.
AHRQ-funded; 290201500002.
Citation: Raman G, Adam GP, Halladay CW .
Comparative effectiveness of management strategies for renal artery stenosis: an updated systematic review.
Ann Intern Med 2016 Nov;165(9):635-49. doi: 10.7326/m16-1053.
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Keywords: Kidney Disease and Health, Treatments, Comparative Effectiveness, Evidence-Based Practice
Nguyen UD, Ayers DC, Li W
Preoperative pain and function: profiles of patients selected for total knee arthroplasty.
The researchers examined patient-reported preoperative pain and function profiles to understand symptom severity at the time of total knee arthroplasty (TKA) decision. Of 6,936 patients, 77 percent had high pain and poor function (group 4), 19 percent had high pain "or" poor function (groups 2-3), and 5 percent had little pain and high function before TKA (group 1).
AHRQ-funded; HS018910.
Citation: Nguyen UD, Ayers DC, Li W .
Preoperative pain and function: profiles of patients selected for total knee arthroplasty.
J Arthroplasty 2016 Nov;31(11):2402-07.e2. doi: 10.1016/j.arth.2016.04.015.
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Keywords: Pain, Surgery, Arthritis, Comparative Effectiveness, Patient-Centered Outcomes Research
Devine EB, Alfonso-Cristancho R, Yanez ND
Effectiveness of a medical vs revascularization intervention for intermittent leg claudication based on patient-reported outcomes.
This study compared the effectiveness of a medical (walking program, smoking cessation counseling, and medications) vs revascularization (endovascular or surgical) intervention for intermittent claudication (IC) in the community, focusing on outcomes of greatest importance to patients. Among patients with IC, those in the revascularization cohort had significantly improved function (Walking Impairment Questionnaire), better health-related quality of life , and fewer symptoms at 12 months compared with those in the medical cohort.
AHRQ-funded; HS020025.
Citation: Devine EB, Alfonso-Cristancho R, Yanez ND .
Effectiveness of a medical vs revascularization intervention for intermittent leg claudication based on patient-reported outcomes.
JAMA Surg 2016 Oct 19;151(10):e162024. doi: 10.1001/jamasurg.2016.2024.
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Keywords: Comparative Effectiveness, Outcomes, Patient-Centered Outcomes Research, Quality of Life, Treatments
Reid MC, Eccleston C, Pillemer K
Management of chronic pain in older adults.
This review summarized recent evidence on the assessment and management of pain in older patients. Evidence is taken from systematic reviews, meta-analyses, individual trials, and clinical guidelines. Based on their review, the authors argue that all older adults with chronic pain should undergo a comprehensive geriatric pain assessment and that a comprehensive assessment can guide selection of treatments most likely to benefit the patient and identify targets for intervention besides pain relief.
AHRQ-funded; HS020648.
Citation: Reid MC, Eccleston C, Pillemer K .
Management of chronic pain in older adults.
BMJ 2015;350:h532. doi: 10.1136/bmj.h532..
Keywords: Care Management, Chronic Conditions, Elderly, Comparative Effectiveness, Evidence-Based Practice, Pain
Pierorazio PM, Johnson MH, Patel HD
Management of renal masses and localized renal cancer: Systematic review and meta-analysis.
This review aimed to summarize evidence on effectiveness and comparative effectiveness of active surveillance (AS), thermal ablation (TA), and radical (RN) or partial nephrectomy (PN) for patients with a renal mass suspicious for localized renal cancer. It concluded that comparative studies demonstrated similar cancer-secific survival across management strategies, with some differences in renal functional outcomes, perioperative outcomes, and postoperative harms that should be considered when choosing a management strategy.
AHRQ-funded; 290201200007I.
Citation: Pierorazio PM, Johnson MH, Patel HD .
Management of renal masses and localized renal cancer: Systematic review and meta-analysis.
J Urol 2016 Oct;296(4):989-99. doi: 10.1016/j.juro.2016.04.081.
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Keywords: Cancer, Evidence-Based Practice, Comparative Effectiveness, Outcomes, Kidney Disease and Health
Brownley KA, Berkman ND, Peat CM
Binge-eating disorder in adults: a systematic review and meta-analysis.
This review summarized evidence about the benefits and harms of psychological and pharmacologic therapies for adults with binge-eating disorder. It concluded that cognitive behavioral therapy, lisdexamfetamine, SGAs, and topiramate reduced binge eating and related psychopathology, and lisdexamfetamine and topiramate reduced weight in adults with binge-eating disorder.
AHRQ-funded; 290201200008U.
Citation: Brownley KA, Berkman ND, Peat CM .
Binge-eating disorder in adults: a systematic review and meta-analysis.
Ann Intern Med 2016 Sep 20;165(6):409-20. doi: 10.7326/m15-2455.
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Keywords: Obesity, Medication, Evidence-Based Practice, Behavioral Health, Comparative Effectiveness
Connolly Gibbons MB, Gallop R, Thompson D
Comparative effectiveness of cognitive therapy and dynamic psychotherapy for major depressive disorder in a community mental health setting: a randomized clinical noninferiority trial.
The authors sought to determine whether dynamic psychotherapy (DT) is not inferior to cognitive therapy (CT) in the treatment of major depressive disorder (MDD) in a community mental health setting. This study suggests that DT is not inferior to CT on change in depression for the treatment of MDD in a community mental health setting.
AHRQ-funded; HS018440.
Citation: Connolly Gibbons MB, Gallop R, Thompson D .
Comparative effectiveness of cognitive therapy and dynamic psychotherapy for major depressive disorder in a community mental health setting: a randomized clinical noninferiority trial.
JAMA Psychiatry 2016 Sep;73(9):904-11. doi: 10.1001/jamapsychiatry.2016.1720.
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Keywords: Comparative Effectiveness, Community-Based Practice, Depression, Behavioral Health, Patient-Centered Outcomes Research
Elliot DL, Goldberg L, MacKinnon DP
Empiric validation of a process for behavior change.
In this report, the researchers compared the process of change for three evidence-based programs that shared theories, intervention elements and potential mediating variables. Each investigation assessed pre- and post-intervention variables using survey constructs with established reliability. Each used mediation analyses to define relationships. They found that knowledge was a significant mediator in each program, and that norms, perceived control abilities, and self-monitoring were confirmed in at least two studies. The researchers concluded that combined findings demonstrate a means to substantiate process aspects and theoretical models to advance understanding of behavior change.
AHRQ-funded; HS022981; HS019456.
Citation: Elliot DL, Goldberg L, MacKinnon DP .
Empiric validation of a process for behavior change.
Transl Behav Med 2016 Sep;6(3):449-56. doi: 10.1007/s13142-015-0343-y.
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Keywords: Behavioral Health, Comparative Effectiveness, Patient-Centered Outcomes Research
Krishnamurthy Y, Cooper LB, Parikh KS
Pulmonary hypertension in the era of mechanical circulatory support.
The researchers summarized the literature available to highlight the definition, pathogenesis, and prognosis of pulmonary hypertension (PH) due to left heart disease (LHD). Additionally, they discussed the use of mechanical circulatory support (MCS) in this population. Then, they provided recommendations regarding the management and reassessment of PH due to LHD in the specific context of MCS.
AHRQ-funded; HS021092.
Citation: Krishnamurthy Y, Cooper LB, Parikh KS .
Pulmonary hypertension in the era of mechanical circulatory support.
ASAIO J 2016 Sep-Oct;62(5):505-12. doi: 10.1097/mat.0000000000000408.
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Keywords: Comparative Effectiveness, Heart Disease and Health, Medical Devices, Respiratory Conditions
Stillman AE, Gatsonis C, Lima JA
Rationale and design of the Randomized Evaluation of patients with Stable angina Comparing Utilization of noninvasive Examinations (RESCUE) trial.
This article describes the RESCUE trial, which is based on the hypothesis that coronary computed tomography angiography as a diagnostic tool is associated with no increase in cardiac risk, decreased cost, and reduced radiation exposure compared with single photon emission computed tomography myocardial perfusion imaging.
AHRQ-funded; HS019403.
Citation: Stillman AE, Gatsonis C, Lima JA .
Rationale and design of the Randomized Evaluation of patients with Stable angina Comparing Utilization of noninvasive Examinations (RESCUE) trial.
Am Heart J 2016 Sep;179:19-28. doi: 10.1016/j.ahj.2016.06.003.
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Keywords: Comparative Effectiveness, Imaging, Cardiovascular Conditions
Bekelis K, Gottlieb D, Su Y
Surgical clipping versus endovascular coiling for elderly patients presenting with subarachnoid hemorrhage.
The authors studied elderly Medicare patients who underwent treatment for ruptured cerebral aneurysms. They did not demonstrate a difference in mortality, rate of discharge to rehabilitation, and readmissions between surgical clipping and endovascular coiling of ruptured cerebral aneurysms, although clipping was associated with a slightly longer length of stay.
AHRQ-funded; HS021581.
Citation: Bekelis K, Gottlieb D, Su Y .
Surgical clipping versus endovascular coiling for elderly patients presenting with subarachnoid hemorrhage.
J Neurointerv Surg 2016 Sep;8(9):913-8. doi: 10.1136/neurintsurg-2015-011890.
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Keywords: Brain Injury, Surgery, Comparative Effectiveness, Outcomes, Elderly
Vemana G, Kim EH, Bhayani SB
Survival comparison between endoscopic and surgical management for patients with upper tract urothelial cancer: a matched propensity score analysis using surveillance, epidemiology and end results-Medicare data.
The researchers sought to determine survival differences among patients receiving endoscopic vs surgical management for upper tract urothelial carcinoma (UTUC). They found that although initial survival outcomes are similar for endoscopic and surgical management of nonmuscle-invasive, low-grade UTUC, both cancer-specific survival and overall survival are significantly inferior for the endoscopic management group in the longer term. They also found that transition from initial endoscopic management to surgical intervention appears to have limited impact on survival.
AHRQ-funded; HS019455.
Citation: Vemana G, Kim EH, Bhayani SB .
Survival comparison between endoscopic and surgical management for patients with upper tract urothelial cancer: a matched propensity score analysis using surveillance, epidemiology and end results-Medicare data.
Urology 2016 Sep;95:115-20. doi: 10.1016/j.urology.2016.05.033.
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Keywords: Cancer, Comparative Effectiveness, Elderly, Mortality, Surgery
Khazanie P, Hammill BG, Patel CB
Use of heart failure medical therapies among patients with left ventricular assist devices: insights from INTERMACS.
The authors examined the use of heart failure medications before and after left ventricular assist devices (LVAD) implant in adult patients enrolled in the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS). They found that overall use of neurohormonal antagonists was low after LVAD implant, whereas use of loop diuretics and amiodarone remained high, and concluded that heart failure medication use is highly variable, but appears to generally increase after LVAD implantation.
AHRQ-funded; HS021092.
Citation: Khazanie P, Hammill BG, Patel CB .
Use of heart failure medical therapies among patients with left ventricular assist devices: insights from INTERMACS.
J Card Fail 2016 Sep;22(9):672-9. doi: 10.1016/j.cardfail.2016.02.004.
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Keywords: Comparative Effectiveness, Heart Disease and Health, Medical Devices, Medication, Patient-Centered Outcomes Research
Wu AC, Butler MG, Li L
Primary adherence to controller medications for asthma is poor.
The objective of this study was to compare real-world adherence, including both primary and secondary adherence, to the major controller regimens (inhaled corticosteroids (ICSs), leukotriene antagonists (LTRAs), or ICS/long-acting b-agonists (ICS/LABAs) in diverse, insured populations. It found that adherence to controller medications is poor and many patients do not ever fill prescriptions for controller medications. However, primary adherence to ICSs was better than to LTRAs and ICS/LABAs.
AHRQ-funded; HS019669.
Citation: Wu AC, Butler MG, Li L .
Primary adherence to controller medications for asthma is poor.
Ann Am Thorac Soc 2015 Feb;12(2):161-6. doi: 10.1513/AnnalsATS.201410-459OC..
Keywords: Asthma, Patient Adherence/Compliance, Medication, Comparative Effectiveness
Simianu VV, Flum DR
Rethinking elective colectomy for diverticulitis: a strategic approach to population health.
The authors argue that a rethinking of elective colectomy should come from a patient-centered approach that considers the risks of recurrence, quality of life, patient wishes and experiences about surgical and medical treatment options as well as operative morbidity and risks.
AHRQ-funded; HS020025.
Citation: Simianu VV, Flum DR .
Rethinking elective colectomy for diverticulitis: a strategic approach to population health.
World J Gastroenterol 2014 Nov 28;20(44):16609-14. doi: 10.3748/wjg.v20.i44.16609..
Keywords: Patient-Centered Outcomes Research, Comparative Effectiveness, Surgery, Adverse Events, Risk
Fitzgerald GK, Fritz JM, Childs JD
Exercise, manual therapy, and use of booster sessions in physical therapy for knee osteoarthritis: a multi-center, factorial randomized clinical trial.
The purposes of this paper are to determine if (1) treatment effects differ between participants receiving manual therapy (MT) with exercise compared to subjects who don't, and if (2) treatment effects are better sustained when participants receive booster sessions compared to those who don't over a one year period in subjects with knee osteoarthritis. The researchers found that MT or use of boosters with exercise did not result in additive improvement in the primary outcome at 1 year. Also, secondary outcomes suggest MT may have some short term benefit, and booster sessions may improve responder status and knee pain at 1 year.
AHRQ-funded; HS019624.
Citation: Fitzgerald GK, Fritz JM, Childs JD .
Exercise, manual therapy, and use of booster sessions in physical therapy for knee osteoarthritis: a multi-center, factorial randomized clinical trial.
Osteoarthritis Cartilage 2016 Aug;24(8):1340-9. doi: 10.1016/j.joca.2016.03.001.
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Keywords: Arthritis, Comparative Effectiveness, Patient-Centered Outcomes Research, Treatments
Sohn W, Resnick MJ, Greenfield S
Impact of adherence to quality measures for localized prostate cancer on patient-reported health-related quality of life outcomes, patient satisfaction, and treatment-related complications.
Given the small number of narrowly focused measures in prostate cancer care, the researchers sought to determine whether adherence to any of the available payer-driven quality measures influences patient-centered outcomes, including health-related quality of life (HRQOL), patient satisfaction, and treatment-related complications. They concluded that compliance with available nationally endorsed quality indicators was not associated with clinically important changes in patient-centered outcomes (HRQOL, satisfaction, or complications) within 1-year.
AHRQ-funded; HS019356; HS022640.
Citation: Sohn W, Resnick MJ, Greenfield S .
Impact of adherence to quality measures for localized prostate cancer on patient-reported health-related quality of life outcomes, patient satisfaction, and treatment-related complications.
Med Care 2016 Aug;54(8):738-44. doi: 10.1097/mlr.0000000000000562.
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Keywords: Cancer, Cancer: Prostate Cancer, Quality of Life, Comparative Effectiveness, Patient Experience
Wilt TJ, MacDonald R, Brasure M
Pharmacologic treatment of insomnia disorder: an evidence report for a clinical practice guideline by the American College of Physicians.
The researchers assessed the benefits, harms, and comparative effectiveness of pharmacologic treatments for adults with insomnia disorder. Their review concluded that eszopiclone, zolpidem, and suvorexant may improve short-term global and sleep outcomes for adults with insomnia disorder, but the comparative effectiveness and long-term efficacy of pharmacotherapies for insomnia are not known.
AHRQ-funded; 290201200016I.
Citation: Wilt TJ, MacDonald R, Brasure M .
Pharmacologic treatment of insomnia disorder: an evidence report for a clinical practice guideline by the American College of Physicians.
Ann Intern Med 2016 Jul 18;165(2):103-12. doi: 10.7326/m15-1781.
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Keywords: Sleep Problems, Comparative Effectiveness, Medication, Evidence-Based Practice
Dagne GA, Brown CH, Howe G
Testing moderation in network meta-analysis with individual participant data.
The authors extended existing network methods for main effects to examining moderator effects. They further studied how the use of individual participant data may increase the sensitivity of network meta-analysis (NMA) for detecting moderator effects. They proposed a new NMA diagram and applied it to data from a classroom-based randomized study that involved two sub-trials, each comparing interventions that were contrasted with separate control groups.
AHRQ-funded; HS020263.
Citation: Dagne GA, Brown CH, Howe G .
Testing moderation in network meta-analysis with individual participant data.
Stat Med 2016 Jul 10;35(15):2485-502. doi: 10.1002/sim.6883.
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Keywords: Comparative Effectiveness, Data, Research Methodologies
Luo Z, Chen Q, Annis AM
A comparison of health plan- and provider-delivered chronic care management models on patient clinical outcomes.
Two contrasting strategies of chronic care management include provider-delivered care management (PDCM) and health plan-delivered care management (HPDCM). The researchers aimed to compare the effectiveness of PDCM vs. HPDCM on improving clinical outcomes for patients with chronic diseases. They found that in a commercially insured population, neither PDCM nor HPDCM resulted in substantial improvement in patients' clinical indicators in the first year.
AHRQ-funded; HS020108.
Citation: Luo Z, Chen Q, Annis AM .
A comparison of health plan- and provider-delivered chronic care management models on patient clinical outcomes.
J Gen Intern Med 2016 Jul;31(7):762-70. doi: 10.1007/s11606-016-3617-2.
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Keywords: Chronic Conditions, Care Management, Primary Care: Models of Care, Primary Care, Healthcare Delivery, Comparative Effectiveness, Patient-Centered Outcomes Research, Health Insurance
Belforti RK, Lagu T, Haessler S
Association between initial route of fluoroquinolone administration and outcomes in patients hospitalized for community-acquired pneumonia.
The objective of this study was to compare outcomes of hospitalized patients with community-acquired pneumonia receiving intravenous vs oral respiratory fluoroquinolones. The authors concluded that there was no association between initial route of administration and outcomes.
AHRQ-funded; HS018723.
Citation: Belforti RK, Lagu T, Haessler S .
Association between initial route of fluoroquinolone administration and outcomes in patients hospitalized for community-acquired pneumonia.
Clin Infect Dis 2016 Jul 1;63(1):1-9. doi: 10.1093/cid/ciw209.
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Keywords: Community-Acquired Infections, Pneumonia, Comparative Effectiveness, Patient-Centered Outcomes Research, Antibiotics
Sawinski D, Trofe-Clark J, Leas B
Calcineurin inhibitor minimization, conversion, withdrawal, and avoidance strategies in renal transplantation: a systematic review and meta-analysis.
The researchers evaluated 92 comparisons from 88 randomized controlled trials and found moderate- to high-strength evidence suggesting that minimization strategies result in better clinical outcomes compared with standard-dose regimens and moderate-strength evidence indicating that conversion to a mammalian target of rapamycin inhibitor or belatacept was associated with improved renal function but increased rejection risk.
AHRQ-funded; 290201200011I.
Citation: Sawinski D, Trofe-Clark J, Leas B .
Calcineurin inhibitor minimization, conversion, withdrawal, and avoidance strategies in renal transplantation: a systematic review and meta-analysis.
Am J Transplant 2016 Jul;16(7):2117-38. doi: 10.1111/ajt.13710.
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Keywords: Transplantation, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Medication
McLean LP, Cross RK
Pharmacodynamic assessment of vedolizumab for the treatment of ulcerative colitis.
This review discusses the chemistry, pharmacologic properties, clinical efficacy, and safety of vedolizumab in ulcerative colitis. It concluded that vedolizumab is a promising new agent for the treatment of ulcerative colitis. Its mechanism of action differs from tumor necrosis factor (TNF)-alpha inhibitors and immune suppressants, allowing it to be used in cases of TNF-alpha inhibitor failure or non-response, or as a first-line biologic drug.
AHRQ-funded; HS018975.
Citation: McLean LP, Cross RK .
Pharmacodynamic assessment of vedolizumab for the treatment of ulcerative colitis.
Expert Opin Drug Metab Toxicol 2016 Jul;12(7):833-42. doi: 10.1080/17425255.2016.1181171.
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Keywords: Comparative Effectiveness, Digestive Disease and Health, Medication, Treatments
Augustine J, Warholak TL, Hines LE
Ability and use of comparative effectiveness research by P&T committee members and support staff: a 1-year follow-up.
The study’s objective was to provide a follow-up assessment of the use of comparative effectiveness research (CER) in the pharmacy and therapeutics (P&T) committee decision-making process, using information collected from participants 1 year after attending a live continuing education program. It concluded that health professionals attending a continuing education CER program reported higher use of CER materials compared with nonattendees.
AHRQ-funded; HS019220.
Citation: Augustine J, Warholak TL, Hines LE .
Ability and use of comparative effectiveness research by P&T committee members and support staff: a 1-year follow-up.
J Manag Care Spec Pharm 2016 Jun;22(6):618-25. doi: 10.18553/jmcp.2016.22.6.618.
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Keywords: Comparative Effectiveness, Education: Continuing Medical Education, Provider: Health Personnel, Provider: Pharmacist
Maruther NM, Tseng E, Huftless S
Diabetes medications as monotherapy or metformin-based combination therapy for type 2 diabetes: A systematic review and meta-analysis.
The purpose of this study was to evaluate the comparative effectiveness and safety of monotherapy and selected metformin-based combinations in adults with type 2 diabetes. It found that the evidence supports metformin as first-line therapy for type 2 diabetes, given its relative safety and beneficial effects on hemoglobin A1c, weight, and cardiovascular mortality (compared with sulfonylureas). AHRQ-funded; 290-201-200007.
AHRQ-funded; 290201200007I.
Citation: Maruther NM, Tseng E, Huftless S .
Diabetes medications as monotherapy or metformin-based combination therapy for type 2 diabetes: A systematic review and meta-analysis.
Ann Intern Med 2016 Jun 7;164(11):740-51. doi: 10.7326/m15-2650.
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Keywords: Comparative Effectiveness, Medication, Diabetes, Evidence-Based Practice, Medication: Safety